How To Use CPT Code 92920

CPT 92920 refers to the percutaneous transluminal coronary angioplasty procedure for a single major coronary artery or branch. This article will cover the description, procedure, qualifying circumstances, when to use the code, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 92920 procedures.

1. What is CPT 92920?

CPT 92920 is a medical code used to describe the percutaneous transluminal coronary angioplasty (PTCA) procedure performed on a single major coronary artery or branch. This procedure involves the use of a balloon-tipped catheter to widen a narrowed or blocked area within the artery, improving blood flow and reducing the risk of heart-related complications.

2. 92920 CPT code description

The official description of CPT code 92920 is: “Percutaneous transluminal coronary angioplasty; single major coronary artery or branch.”

3. Procedure

The 92920 procedure involves the following steps:

1. The patient is prepped and anesthetized.
2. A small incision is made over the brachial or femoral artery.
3. A guide wire is inserted through the incision into the artery.
4. A guide catheter is inserted over the guide wire and advanced to the coronary artery.
5. Dye is injected, and X-ray imaging is used to visualize blood flow and catheter placement.
6. A balloon-tipped catheter is advanced to the lesion in the coronary artery.
7. The balloon is inflated to compress the plaque against the artery wall, widening the artery and restoring blood flow.
8. The provider checks for bleeding, removes instruments, and closes the incision.

4. Qualifying circumstances

Patients eligible to receive CPT code 92920 services are those with significant coronary artery disease, including those experiencing chest pain, shortness of breath, or other symptoms indicative of reduced blood flow to the heart. The procedure may also be performed in patients with a high risk of heart attack or other cardiac events. A thorough evaluation, including diagnostic tests such as angiography, is necessary to determine the appropriateness of the procedure for each patient.

5. When to use CPT code 92920

CPT code 92920 should be used when billing for a percutaneous transluminal coronary angioplasty procedure performed on a single major coronary artery or branch. This code is appropriate when the procedure is medically necessary and supported by appropriate documentation, including diagnostic test results and a detailed description of the patient’s symptoms and medical history.

6. Documentation requirements

Documentation supporting a claim for CPT 92920 should include:

• A detailed medical history and physical examination.
• Results of diagnostic tests, such as angiography, confirming the presence of significant coronary artery disease.
• A description of the patient’s symptoms and their impact on daily activities.
• Documentation of conservative treatment measures attempted, if applicable.
• A detailed operative report, including a description of the procedure, instruments used, and any complications encountered.
• Postoperative care instructions and follow-up plans.

7. Billing guidelines

When billing for CPT code 92920, it is essential to follow established coding guidelines and rules. Ensure that the procedure is medically necessary and supported by appropriate documentation. Additionally, be aware of any payer-specific requirements or policies related to the use of this code. It is also important to review any relevant coding updates or changes, as these may impact the appropriate use of CPT 92920.

8. Historical information

CPT 92920 was added to the Current Procedural Terminology system on January 1, 2013. There have been no significant updates to the code since its addition.

9. Similar codes to CPT 92920

Five similar codes to CPT 92920 include:

• CPT 92921: This code is used for PTCA procedures involving each additional coronary artery or branch.
• CPT 92924: This code describes atherectomy procedures for a single coronary artery or branch.
• CPT 92925: This code is used for atherectomy procedures involving each additional coronary artery or branch.
• CPT 92928: This code covers coronary stent placement for a single coronary artery or branch.
• CPT 92929: This code is used for coronary stent placement involving each additional coronary artery or branch.

10. Examples

Here are 10 detailed examples of CPT code 92920 procedures:

1. A 55-year-old patient with a history of angina undergoes PTCA for a significant stenosis in the left anterior descending coronary artery.
2. A 65-year-old patient with a history of myocardial infarction undergoes PTCA for a significant stenosis in the right coronary artery.
3. A 70-year-old patient with a history of congestive heart failure undergoes PTCA for a significant stenosis in the left circumflex coronary artery.
4. A 60-year-old patient with a history of unstable angina undergoes PTCA for a significant stenosis in the left main coronary artery.
5. A 50-year-old patient with a history of diabetes and angina undergoes PTCA for a significant stenosis in the obtuse marginal branch of the left circumflex coronary artery.
6. A 45-year-old patient with a history of smoking and angina undergoes PTCA for a significant stenosis in the diagonal branch of the left anterior descending coronary artery.
7. A 75-year-old patient with a history of hypertension and angina undergoes PTCA for a significant stenosis in the posterior descending coronary artery.
8. A 62-year-old patient with a history of hyperlipidemia and angina undergoes PTCA for a significant stenosis in the intermediate branch of the left anterior descending coronary artery.
9. A 58-year-old patient with a history of coronary artery disease and angina undergoes PTCA for a significant stenosis in the ramus intermedius coronary artery.
10. A 67-year-old patient with a history of angina and a positive stress test undergoes PTCA for a significant stenosis in the first diagonal branch of the left anterior descending coronary artery.